Edward Marx, Healthcare CIO Of The Year

Texas Health Resources CIO Edward Marx, honored by HIMSS and CHIME, recognized the importance of technology in healthcare after a personal crisis.

Texas Health Resources CIO Edward Marx started his career with a commitment to healthcare, not technology, but he settled on promoting the effective implementation of technology as the way he could make the biggest contribution to healthcare.

Edward Marx, CIO Texas Health Resources

Last week, he was named the recipient of the 2013 John E. Gall Jr. CIO of the Year Award, which will be presented at the Annual HIMSS Conference and Exhibition in Orlando, Fla., on Feb. 25. The winner was selected by the boards of the Healthcare Information and Management Systems Society (HIMSS), the healthcare IT leadership organization; and the College of Healthcare Information Management Executives (CHIME), which is specifically for CIOs. Marx is senior vice president and CIO at Texas Health Resources in Arlington, one of the largest faith-based, nonprofit healthcare delivery systems in the United States and the largest in North Texas by patients served.

In an interview earlier this week, Marx said the award was as much a reflection on all the people he works with as on himself. "Even though I'm not an IT person by training, I am a leader," he said. He has succeeded by surrounding himself with good people and by understanding the business and clinical aspects of healthcare well enough to know how technology can contribute.

Marx got his first hospital job in high school working as a janitor and saw healthcare as an industry he wanted to be involved in "because it's about people -- about helping people." When he joined the Army Reserve to help pay for college, he initially wanted to be a combat medic for that reason, although he wound up as a combat engineer instead. "As I was in school, it became clear I wasn't going to be a doctor or anything like that," he said.

Still, when it came time to pick a civilian career, he chose to become an anesthesia technician. It was a job that was probably below what he was expected to take as a college graduate and Army officer, "but it got me in the door and gave me some experience in a clinical setting." From there, he sought out a variety of leadership roles -- until the day a personal crisis focused his attention more sharply on technology.

Technology becomes personal"I had a very personal event, where a child of mine was born in very difficult circumstances, and it was actually technology that saved her life," Marx said. You can read his blog post about the experience, but here's the short version he shared with me: "My daughter was born without life. They resuscitated her, but then we were faced with a major choice: whether to take her to a children's hospital a couple of hours away where she would get better care, but there would also be a lot of risk from the flight. My wife was also hospitalized from trauma associated with the birth." He didn't want to separate mother from child or take unnecessary risks if he could help it.

All this happened in the hospital where Marx was working at the time as a physician services coordinator and had just begun to do some work with the hospital's IT group. The doctors at the children's hospital said they could consult remotely if given an automated way to collaborate, but this was in the early 1990s when such things were not common. Yet Marx and the IT team figured out a way to make it happen over a 2400-baud modem.

"We were able to give the physicians at the childrens hospital access to dial into our clinical systems and consult in real-time, see all the data while they were talking with the docs at our hospital." With that remote assist, his daughter survived the crisis. This year she turned 18.

"That really was a trigger point," Marx said, an event that showed him the potential of health IT to make a difference in people's lives. He has also blogged about a more recent event, the death of his mother, and how seeing the shortcomings of the information available to her care team made him recommit to achieving what he calls "meaningful, meaningful use" of health IT.

First to achieve "meaningful use"As a healthcare technology leader, Marx says it's his job "to enable superior business and clinical outcomes." He took on his first CIO role at Parkview Medical Center in Pueblo, Colo., and later served as CIO of University Hospitals of Cleveland, with another IT leadership role at HCA in between. He arrived at Texas Health Resources as CIO in October 2007.

"I always had a great team, but when I arrived at Texas Health, everything came together -- an excellent organization, a very proactive culture, a great team of leaders, and a great IT organization. While I had leadership capabilities, it was really those things coming together that made the difference."

One key achievement: "We implemented EHR very, very well, and at the time we did it, five or six years ago, most people did not implement well. We were first in the country -- or tied for first in the country -- to achieve meaningful use," he said, referring to the federal incentives program for effective use of health IT. Texas Health implemented Epic electronic health record software across a network of 14 hospitals.

The Texas Health IT team also has received a number of awards for innovation, most recently the HIMSS Davies Award.

Perhaps more importantly, the most recent physician engagement scores, a measure of satisfaction with IT systems, are well over 90%, he said. "That's ridiculously high," he chortled. "Physicians, for one thing, are very difficult to satisfy, so to have that level of satisfaction with IT systems is pretty unheard of." Broader surveys of hospital users, he told us, put satisfaction at over 80%.

Making a national mark"I'm not a big techie, but I believe in surrounding myself with knowledgeable, excellent people, including excellent technologists," said Marx. "I also have a national perspective. I blog a couple of times a month, and those blogs are very, very popular. Most of my blogs are about leadership and developing leaders. It's one thing to do healthcare IT well, within your own organization -- that's really good, that's really important -- but if you really want to make your mark, you need to go outside the boundaries of your institution. To add value externally, to others -- that's like the ultimate to me."

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I really appreciate Marx's sentiment about leadership by example. The best leaders in organizations where I've worked understand the difference between being hands-on during a crisis and micro-managing to the extent that competent employees doubt their own ability to solve problems.

Ed Marx was one of 20 health IT leaders we highlighted in our 2013 IW Healthcare leadership issue. In that, he offered this perspective between strategic and hands-one work:

Marx says the ideal CIO role in a big organization like THR should be 90% strategic and 10% operational. But when there are fires to put out, "I'm going to jump in and help my team," he says. "So my role is probably split more like 70% strategic and 30% operations."

The fact that Marx doesn't talk technology to other executives but has a gut instinct for the technology important to the business tells me a lot. He is not cut from the common CIO mold but appears to relish the role none the less. More power to him.

Dave, I can't say what Marx's view of himself as non-techie says about his leadership skills. He obviously has many! But your description of the heart-wrenching birth of his daughter and his role helping to figure out how to collaborate with specialists long-distance over over a 2400-baud modem, speaks volumes.

Are the best CIOs technologists also? Marx doesn't classify himself as a techie and says in fact those with technical backgrounds need to learn all the other skills a CIO needs for success. He said he could have been equally successful in another sort of leadership role, although once he decided to focus on IT leadership he did have to learn specific skills.

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